The very idea of infertility might make some people uncomfortable. But if a couple is determined to start a family, but are still having trouble getting pregnant after several months of having unprotected sex than it is one of those things that need to be looked at. This means both the woman and the man need to be checked. Often, it could be some minor medical problem that can be easily taken care of.
Common causes of infertility include pelvic infection, endometriosis and fibroids. Sometimes it is just irregular periods or unexplained infertility For men, it could be a low sperm count.
Another issue that comes up is many women are waiting longer to have a child explained Dr. Barry Richter.
“After 35 years of age, fertility can start decreasing in terms of reproductivity,” says Dr. Richter. “We have a fairly large group of women that are in that age group that they are trying to get pregnant for the first time and having trouble.”
The rule of thumb used for infertility is having unprotected sex for 12 months. But in cases of painful or abnormal menstrual cycles or painful intercourse, the women should have it looked at right away. Especially if the woman is nearing 40 or older and is anxious to get pregnant says Dr. Richter.
If there are some concerns about whether there is an infertility problem, the first step for couples is to see an OB/GYN who treats these problems.
“It is important to seek appropriate treatment without blindly taking tablets to induce ovulation which is a common incorrect practice in some countries,” says Dr De Alwis.
Typically, a woman will take a urine test which measures the hormone that causes ovulation. Women may also be asked to take their basal body temperature over two or three menstrual cycles to track temperature changes that occur with ovulation. The urine test and basal body temperature can be done at home.
Other tests that can be done in the doctor’s office may involve an ultrasound, saline infusion sonogram or a hysteroscopy, which are used to c+
heck the uterus for fibroids, polyps and other problems that may affect the woman’s ability to get pregnant.
Depending on the symptoms, some tests may be needed at the hospital.
Under special circumstances, a laparoscopy procedure may be recommended. The procedure uses a small telescope-like device inserted through a small cut in the navel. The doctor can look at the fallopian tubes, ovaries and uterus.
For men, a semen analysis is a key part of the basic evaluation and requires a sample. The sample is then evaluated for number, shape, movement and signs of infection. The man may also be referred an urologist for further evaluation.
Treatments on island
Lifestyles changes may be needed to increase the chances of fertility. Smoking, caffeine and alcohol are factors that may impact fertility. Weight, stress, and diet can also impact fertility
Medication or injections to induce women to ovulate regularly is a common treatment and available on island. Surgery can also be done to correct endometriosis or fibroids.
Artificial insemination is another easy treatment that can be done in the office. This involves harvesting the best quality sperm from a sample and using a tiny catheter to inject the specimen into the uterus, near the fallopian tubes. The procedure is painless and patients say they hardly feel the catheter at all, because it is so small and soft.
The key is timing, inducing ovulation, and preparation of the specimen explained Dr. Richter.
“The more difficult patients are those with unexplained fertility, when everything seems to be fine,” says Dr. Richter.
About 20 to 30 percent of patients with unexplained fertility can be treated successfully with artificial insemination. But if the patient hasn’t gotten pregnant in three to six months of artificial insemination treatments, Dr. Richter recommends seeking a referral to overseas specialist for in vitro fertilization.
“If the patient has blocked fallopian tubes or the sperm count is very low – there is not a lot we can offer patients on the island. They usually need to refer to off the island for in vitro fertilization,” says Dr. Richter.